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Abstract: SA-PO1020

Urinary Tract Infections Caused by Carbapenemase-Producing Enterobacteriaceae in Kidney Transplant Patients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Monteiro, Ariane Baptista, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
  • Perotti, Ana Clara Esteves, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
  • Meinerz, Gisele, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
  • Keitel, Elizete, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, Brazil
Background

Patients undergoing kidney transplantation, due to changes in urogenital anatomy and the use of immunosuppressive medications, are more susceptible to infections, with urinary tract infections (UTI) being the most common. The emergence of carbapenemase-producing enterobactéria (CPE) as causes of infectious events in this population is a concern. This study aims to describe kidney transplant patients who presented CPE urinary tract infection and the outcome of these patients in the first year after the procedure. Objective: to describe kidney transplant patients who presented CPE urinary tract infection and the outcome of these patients in the first year after the procedure.

Methods

Retrospective observational study of adult and pediatric patients undergoing kidney transplantation between January 2014 and December 2022, in a hospital in southern Brazil, who presented with asymptomatic bacteriuria, simple cystitis and complicated CPE UTI in the first year after the procedure. The project was approved by the Ethics and Research Committee of Santa Casa de Misericórdia de Porto Alegre, CAAE 54930022.9.0000.5335.

Results

During the period, 2119 patients underwent kidney transplantation, 59 (2,8%) presented with asymptomatic bacteriuria and 128 (6,0%) at least one UTI episode due to CPE (figure 1) with a median of 26 days after surgery. Recurrent infection occurred in 62 (48,4%) of UTI patients. The most prevalent microorganism was Klebsiella pneumoniae and the resistance mechanism was Klebsiella pneumoniae carpapenemase (KPC). Patient outcomes are detailed in figure 1.

Conclusion

Almost 6% of patients had at least one episode of UTI by CPE. The median time until the first UTI was 26 days. One year graft loss and mortality rate in patients with UTI were 23,4% and 13,3%, respectively. The findings of this cohort highlights the incidence and the negative repercussion of this infection on renal transplant recipients.

Figure 1. Kidney transplant patients flow during the study.